Document Detail


Initial cytomegalovirus prophylaxis with ganciclovir: no guarantee for prevention of late serious manifestations of CMV after solid organ transplantation.
MedLine Citation:
PMID:  16301763     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A 37-year-old woman presented with malaise, upper abdominal pain and fever seven months after renal transplantation. She was seronegative for cytomegalovirus (CMV) and had received a kidney from a seropositive donor. She had received CMV prophylaxis (oral ganciclovir) for three months after transplantation. During this period all tests for CMV remained negative. On admission, she presented with symptoms compatible with an acute abdomen and with deterioration of renal function. On emergency laparotomy a perforation of the ileum was found. The resected specimen showed an ulcer with vasculitis at the site of perforation, with both microscopic (owl's eye inclusion bodies), as well as immunohistochemical evidence for a CMV infection. CMV can reactivate (usually in the first three months) after transplantation, sometimes resulting in serious morbidity. The use of antiviral prophylaxis during and after transplantation has certainly decreased the number and severity of CMV infections. This case illustrates that life-threatening infections such as CMV can still emerge a long time after transplantation. Unrelenting awareness of this condition is mandatory, even after apparently adequate anti-CMV prophylaxis.
Authors:
M Zandberg; E F de Maar; H S Hofker; J J Homan van der Heide; S Rosati; W J van Son
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  The Netherlands journal of medicine     Volume:  63     ISSN:  0300-2977     ISO Abbreviation:  Neth J Med     Publication Date:  2005 Nov 
Date Detail:
Created Date:  2005-11-22     Completed Date:  2005-12-20     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0356133     Medline TA:  Neth J Med     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  408-12     Citation Subset:  IM    
Affiliation:
Department of Internal Medicine, Division of Nephrology, Groningen University Medical Centre, Groningen, the Netherlands. marietzandberg@hotmail.com
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MeSH Terms
Descriptor/Qualifier:
Adult
Antiviral Agents / therapeutic use*
Cytomegalovirus / physiology
Cytomegalovirus Infections / etiology*,  prevention & control
Female
Ganciclovir / therapeutic use*
Humans
Kidney Transplantation / adverse effects*
Time Factors
Virus Activation
Chemical
Reg. No./Substance:
0/Antiviral Agents; 82410-32-0/Ganciclovir

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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